Dr. SHWETA PARAKH

Dr. LUTHRA SAURABH, Dr. ROHAN CHAWLA, Prof.Dr. SEEMA KASHYAP

Abstract

A 57-year-old female presented to us with 4 episodes of low grade recurrent vitritis and 1 episode of OS optic neuritis from May 2010-2014, all of which responded well to steroid therapy. Initial routine uveitis investigations were normal. After being lost to follow-up for 7 years, she returned in January 2021 with recurrent low grade vitritis OU and widespread RPE alteration with SRF at the macula OS. SD-OCT showed thick band-like sub-RPE infiltration above the Bruch’s membrane bilaterally. FFA showed “leopard spot” appearance OS. Smears from a diagnostic vitrectomy +IHC stain were suggestive of T-cell PVRL. CSF morphology, bone marrow preparation, whole body PET CT scan & MRI brain were normal. A diagnosis of bilateral T- cell PVRL with ocular involvement only was made. She has received Intravitreal methotrexate 400 mcg/0.1 mL (18 OD ,19 OS) and is currently in remission. In conclusion, peculiar multimodal imaging features help in diagnosing PVRL, known to be a great masquerader.

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